PHSI Creates Pharmacy Chain MAC to Meet PBM Contract GER Guarantee

IndustryManaged Care/ PBM
ProblemA PBM contracted with a national pharmacy chain for a MAC list with a specific Generic Effective Rate (GER) guarantee. The PBM’s current MAC list did not achieve the contracted GER rate.
PHSI SolutionTo meet the GER guarantee, PHSI utilized pharmacy claims data to create a MAC list specific for that pharmacy chain that met the contracted GER rate.
ResultsPHSI was able to provide the PBM the information that would ensure the GER for the contracted retail chains, meeting the contractual agreement with the pharmacy chain. PHSI continues to update the MAC lists to continue to meet these guarantees based on market pricing and utilization changes.